Friday, July 17, 2015

To the Parents of James Holmes

The World May Blame Your Son, but We Know the Truth, and We Support You
10 million children will grow up to be adults who have
serious mental illness like James Holmes. Like our children. 


Twenty doctors agree that James Holmes has schizophrenia, a mental disorder that has been described as “young person’s dementia.”   But the fact of his illness did not prevent Colorado jurors from finding the young man, who opened fire in an Aurora theater in 2012, guilty of 24 counts of murder in the first degree, two counts for each victim.  After the verdict, a girlfriend of one of the victims declared, “This is a huge step forward.” 

The shooting was truly awful, and the grief and even anger of the victims’ families is entirely comprehensible. But the parents of the ten million U.S. children with serious mental illness, children like James Holmes, feel differently. We see the verdict as a huge step backward, a clear message that the stigma and discrimination associated with mental illness is as strong as ever, and that the public’s fear and ignorance of mental illness have not abated since 2012.

Mass shootings are incredibly rare, representing only two percent of all gun violence in the United States. Yet the daily tragedies—incarceration, homelessness, suicide—that disproportionately affect our children who have serious mental illness do not make the headlines.

In December 2012, after another mass shooting involving a young man who likely had serious mental illness, I wrote an essay sharing my own family’s struggles to find mental healthcare for my then 13-year old son. The essay, “I Am Adam Lanza’s Mother,” became a rallying cry for mothers who had tried and failed for years to find treatment that worked for their children.  As a result of my cry for help, my son was diagnosed with bipolar disorder and got treatment that works. Today, he is in a mainstream school earning good grades, hanging out with his friends, and planning for college. With treatment, my son is no more likely to be violent than anyone else.

In the wake of the Newtown tragedy, I was also able to connect with a passionate community of mental health advocates. Eight of these mothers, all powerful advocates in their own right, wrote letters to Robert and Arlene Holmes.  Here is some of what they shared:

Last summer my 12-year-old daughter Morgan was charged with the crime that would be dubbed by the media as the “Slender Man Stabbing.” One moment she and her two best friends were eating donuts at my kitchen table. The next moment, she had been charged with a crime of unimaginable violence, and was torn suddenly and unexpectedly from my home. You have expressed feeling guilt for not knowing your son had mental illness. I know how that feels. I didn't know that my daughter was sick, either.—Angie Geyser

We managed to keep our son out of the criminal justice system until 2012. He does not think he has a mental illness even though he has spent the majority of his adult life in locked psychiatric facilities. Today he sits in jail awaiting a bed in a state hospital. We all believe in treatment before tragedy!—Teresa Pasquini

It wasn’t your beautiful son who hurt all those people.  It was the untreated brain illness that is so misunderstood.  It is my hope that we can educate people to understand that people with schizophrenia are not evil; they are ill. —Kathy Day

More children in this country die by suicide than cancer, diabetes, and every birth defect combined, but somehow, trying to keep our son alive was considered “bad parenting.” We learned that our son’s illness is in his brain, not in his upbringing. We could have so easily been where you are.—Tom and Chrisa Hickey

I hope your son is judged with compassion and given the help and care he needs. I also hope you know that you are not alone in this. We have a community of parents and caregivers of those with serious mental illnesses, and we care and support each other.
—Marcie Bitler Sohara

Our son was an adult now, and his right to have irrational thoughts flying loose in his mind were supported by maladaptive laws written in the 1960s that make one thing crystal clear: after age 18, our boy would have to present as a “danger to self or others” if he was ever going to be returned to a safe residential facility. The deinstitutionalion experiment has cost countless lives; families have lived with personal tragedies of lost loved ones for decades without anyone taking notice. Only when our sick kids explode in the community do people share an opinion. You are not alone. —Jennifer Hoff

Please don’t blame yourself. It’s not your fault; it’s not your son’s fault; it’s not your husband’s fault. It’s your son’s brain disease. It’s our broken mental health system. It’s the lack of funding to find a cure and lack of education to each school administrators, family members, judges, law enforcement, and lawmakers. —Marla Durkin-Pope

My hope for you both is that you find comfort and kindness in those of us who, even in a small way, understand and empathize with the experience you now have to go through.  We wish you could have known earlier that there were people much like you, struggling to find answers, comprehend, and keep ourselves afloat. —Jenifer and Jim Walsh


Their letters are reprinted in full with their authors’ permission below.

***

Dear Robert and Arlene,

We want you to know that you are not alone. There is an entire community of parents who understand and support you. We are the mothers of children who have been diagnosed with serious mental illness. Some of our children have committed violent crimes, and some of us simply understand how these tragedies can occur as a result of a brain disease.

Last summer my 12-year-old daughter Morgan was charged with the crime that would be dubbed by the media as the “Slender Man Stabbing.” One moment she and her two best friends were eating donuts at my kitchen table. The next moment, she had been charged with a crime of unimaginable violence, and was torn suddenly and unexpectedly from my home.

You have expressed feeling guilt for not knowing your son had mental illness. I know how that feels. I didn't know that my daughter was sick, either. She was only diagnosed with schizophrenia after being declared incompetent to stand trial and being evaluated at a state psychiatric facility. I feel as though my guilt for not knowing Morgan was sick will forever consume me from the inside out.

Please do not hesitate to reach out to us for support. If you feel uncomfortable doing that, please know we all hold you close to our hearts.

Angie Geyser

***

Dear Mr. and Mrs. Holmes,

I am the proud mom of a 32-year-old adult son who has a 16-year history with serious mental illness. He was diagnosed at the age of 16 with bipolar disorder following his first hospitalization. He has been involuntarily hospitalized over 50 times. His diagnosis has changed to schizoaffective disorder. He suffers from a lack of insight, which is called anosognosia. He does not think he has a mental illness even though he has spent the majority of his adult life in locked psychiatric facilities.

We managed to keep our son out of the criminal justice system until 2012 when he was arrested while on a hospital unit at Napa State Hospital in California and charged with assault. He has been deemed incompetent to stand trial four times. Today he sits in jail awaiting a bed in a state hospital.

In May 2015, I travelled to Washington DC to speak on Capitol Hill about my family’s tragedy. I joined families from across the nation who refuse to be silent and let our families and communities continue to suffer. We all believe in treatment before tragedy!

Your son and your family are in my heart and thoughts. We are with you, and you are not alone.

My best,
Teresa Pasquini

***

Dear Mr. and Mrs. Holmes:

My family member suffers from schizoaffective disorder with constant psychosis. There’s just something about psychotic illnesses that make us all feel alone.  It’s so isolating.  In James’s case, it’s worse because his illness impacted so many others. The system should have provided treatment to him to prevent tragedies that happen too often.

I’m so thankful that my family member has not hurt anyone--yet.  But for the last four months, he’s mostly stayed in his room.  He lives in fear every day because his “spirits” constantly threaten his life.  I can’t leave him alone at times, because his fear of being killed is so great.  I worry that these spirits will cause him to act out and hurt himself or someone else.  I know that my loved one could experience what your son’s illness did to him.

I’m fortunate because he lives with me.  I can keep an eye on him and am aware of changes that could be red flags.  You weren’t in the same town, let alone the same state as James.  There is no way you could have known what his illness was planning.

And that’s just it.  It’s the illness that controlled him.  It wasn’t your beautiful son who hurt all those people.  It was the untreated brain illness that is so misunderstood.

I hope James gets the treatment he needs and deserves.  And I hope you both can have some peace.  You hear some very ignorant statements about your son.  It is my hope that we can educate people to understand that people with schizophrenia are not evil; they are ill. 

I’m sending good thoughts to you and your family.  I hope you know that you are not alone, and there are many of us who would welcome you!

Sincerely,

Kathy Day

***

Dear Robert and Arlene:

People look at me cross-eyed when I say we're lucky my son Tim was diagnosed with schizophrenia as a child. 

He was 11 when we first got the diagnosis, the last in a long line of them, from autism to speech disorders to depression and bipolar disorder. He was in a psychiatric hospital when he was diagnosed, after a suicide attempt that forced us to acknowledge he was sick.  Three years and 11 hospitalizations later, we made the agonizing decision to put Tim into long-term residential treatment because he was so delusional and so violent that we feared for his safety, our safety, and the safety of our other children.

We were alone then. We were accused of filling him with poisonous medication because we didn't feel like creating structure or enforcing rules. Strangers cursed us when he had a meltdown in public. Acquaintances felt justified in beating their breasts and declaring they would never send their children away. More children in this country die by suicide than cancer, diabetes, and every birth defect combined, but somehow, trying to keep our son alive was considered “bad parenting.”

In residential treatment, Tim learned what it was like to live without the voices. And since he was still a child, we were able to ingrain in him the importance of his meds and therapy to keep the voices at bay. We learned that our son’s illness is in his brain, not in his upbringing. He's 21 now.  He can never be left alone for more than an hour, or his anxiety and paranoia kick in.  He takes his meds, and today, they are working.

But I remember watching him being frisked by the sheriff we had to call after he broke every door in the house and threatened to kill us. There's a razor thin line between that day and today. We spend every day staving off a return to that day.  We know we're lucky to have the opportunity to do so. We could have so easily been where you are. 

We will continue to keep you in our prayers. 

Tom and Chrisa Hickey

***
Dear Robert and Arlene,

I have a 26 year old son who has been diagnosed with paranoid schizophrenia. He was only 19 when he had a complete break with reality, and we were able to get a diagnosis. I have been luckier than most because he knew something was wrong, and we were able to get help; however, I am fully aware that might not have been the case. I tell you this because I want you to know that the pain and the suffering you and your son are going through are always on my mind.

I know that the seriously mentally ill are operating with a sick brain, and your son’s actions were due to that sickness. I hope your son is judged with compassion and given the help and care he needs. I also hope you know that you are not alone in this. We have a community of parents and caregivers of those with serious mental illnesses, and we care and support each other. I hope you can find us and take some comfort in knowing you are not judged by us.

Sincerely,

Marcie Bitler Sohara

***

Dear Arlene and Robert,

I want to thank you for speaking up in response to the “evil” and “monster” taglines used liberally by the media towards your son James. Thank you for being brave enough to endure people spewing anger and hatred towards you as you attempt to educate our nation on the painful reality that serious mental illness can be fatal if left untreated and how a devastating psychiatric diagnosis like schizophrenia can wreak havoc on an individual’s life, stealing the ability to reason and decide rationally and potentially leading to tragic outcomes.

I cannot imagine how you must feel as parents, going through the courtroom experiences when what your son really needs and deserves is to be in a psychiatric hospital. I understand personally about losing an adult child to an illness that steals his mind and free will, and I know what it is like to watch helplessly as people judge and condemn your child for behaviors resulting from a brain that is too sick to understand the consequences.

My 22-year-old son is mentally ill and spent the majority of his childhood and all of his adolescence in clinical day programs or locked residential facilities “for safety.” Despite the fact that he was disabled, receiving SSI, and was never was never able to manage his life in a safe manner, when he aged into adulthood, he received his shoe laces back and a plane ticket “home “and free reign to manage his life completely without “interference from his parents” (his case manager’s words).

Within months of returning home, he had multiple run-ins with the law, several psychiatric hospitalizations, and he was kicked out of two group homes. We begged our county health department to put him in a hospital. We presented 500 pages of medical records and his doctors’ letters advising he be reinstitutionalized for treatment of his illness. This meant nothing to Orange County. Our son was an adult now, and his right to have irrational thoughts flying loose in his mind were supported by maladaptive laws written in the 1960s that make one thing crystal clear: after age 18, our boy would have to present as a “danger to self or others” if he was ever going to be returned to a safe residential facility. There was nothing his father and I could do but watch helplessly as he was consumed by the revolving door.

He went missing for days at a time, and started smoking pot and drinking often. We were constantly worried, not only of what would happen to him but also about collateral damage that might be inflicted in the community. Less than 36 hours after his last release, he walked into Bank of America with a threat scribbled on a sticky note to blow up the place if the teller didn’t hand over a thousand dollars. He will spend the next 13 years in the California State Prison. He has spent many months in solitary confinement and now has “Crazy Boy” literally tattooed across his young face; despite this, he has been denied his psychiatric medicine because he is not “sick enough.” in other words, we have to wait until his mental state declines even more before he qualifies for his psychiatric meds that he has taken since age 12.

Our jails have become hospitals, but they use pepper spray instead of a syringe. Nearly percent of prison inmates have a serious mental illness. The deinstitutionalion experiment has cost countless lives; families have lived with personal tragedies of lost loved ones for decades without anyone taking notice. Only when our sick kids explode in the community do people share an opinion. You are not alone. I am praying for everyone who has been impacted by our broken mental health system and for treatment for James.

Kindly,

Jennifer Hoff

***

Dear Robert and Arlene,

I have a 30-year old daughter who has been sick since high school. When her problems first started, we took her to psychologist who diagnosed her with “normal teenage defiance.” For ten years, no one knew what was going on in her beautiful sick brain. They call it “presenting well.” In secret, she sees aliens, a FBI informant, the Messiah, and I can go on and on. Finally, after ten years, her illness got so bad that other signs related to schizophrenia became apparent.

It took three misdiagnoses from professionals and education on my part to really grasp what was going on when those external signs started to become apparent. Please don’t blame yourself. It’s not your fault; it’s not your son’s fault; it’s not your husband’s fault. It’s your son’s brain disease. It’s our broken mental health system. It’s the lack of funding to find a cure and lack of education to each school administrators, family members, judges, law enforcement, and lawmakers.  

There are many parents like you out there who support you, love you, and will be there in spirit with you every day in that court room! Please come to our groups on Facebook. You have a support system of loved ones whose family members have a brain disease like your son. Become advocates. You have the support to fight for your son’s life, and his life matters!

Hugs!

Marla Durkin-Pope

***

The bravest are the most tender – The loving are the daring. –Bayard Taylor

Dear Robert and Arlene,

Underneath the sullen and distant fa├žade lies the heart of a sweet young man.  Our son longed to be free. 

At the tender age of 13, our son attempted to end his life so that he would no longer be tormented by the voices, commands and “Book” in his head that told him to do things.  Our son struggled with violence at home, epic meltdowns, running away, isolation, threatening suicide constantly, and enormous anxiety and paranoia since age 7.  I read more than I ever thought I could read.  I was mocked by psychologists and condescended to by psychiatrists, until my son’s suicide attempt resulted in a diagnosis of early onset schizophrenia. 

When he had his psychotic break, he spent 42 days in a behavioral health hospital, where he was finally put on the last resort medication.  We are grateful and fortunate that it is working for him and keeping the suicidal ideation and hallucinations away.  We also know the damage that has been done to our family.  Another of my sons has a serious mental illness as well.  We struggle.

My hope for you both is that you find comfort and kindness in those of us who, even in a small way, understand and empathize with the experience you now have to go through.  We wish you could have known earlier that there were people much like you, struggling to find answers, comprehend, and keep ourselves afloat.

Brene Brown shared “Empathy’s the antidote to shame: The two most powerful words when we’re in struggle: me too.”

Your family is in our prayers.  Please let yourselves be supported.

With love,

Jenifer and Jim Walsh


Monday, June 29, 2015

Family Values

Lessons from two very different flags

Our family is complicated. Like many other Americans, my second husband Ed and I are both divorced from our first spouses. Ed has no children of his own and thinks that “our” four (plus our very lively cat) are more than enough. My children’s father has also remarried, so my children have step-siblings and a half-sibling to add to their postmodern family tree. We are all white and middle class, and we live in one of the most politically conservative and the least racially diverse states in the nation: Idaho.

One of the biggest challenges of raising children after a divorce is navigating the space between very different sets of parental values. My younger two children are being raised in a faith tradition that historically discriminated against blacks and that continues to prescribe rigid gender roles.  I support their father’s decision to take them to the Mormon church because I don’t think religion is worth fighting about, and because my own Latter-day Saint parents managed to raise children who were respectful and tolerant of others. But I cannot remain silent about my values, even when they conflict with what my children learn in church.

In light of a landmark week for gay rights and racial discrimination, I asked my children what they knew about two very different flags. “A flag is a symbol,” my 11 year old told me. “It represents a country or an organization.” As we talked about the Confederate flag, I asked them what it symbolized. “Isn’t it the Civil War or something?” my 10 year old daughter said. I explained that for many people, the flag was associated with slavery and oppression.

“But didn’t Dr. Martin Luther King fix all that?” my daughter said. “I thought he made it so that black people and white people were equal.”

White people say things like this all the time. They say, “Oh, we have a black president now, so we can’t be a racist country,” or “Oh, we have affirmative action policies, so white males are actually the victims of discrimination” (Yes, I have actually heard this phrase come out of more than one white man’s mouth).

If there’s one thing we’ve learned over and over again these past few years, from the Trayvon Martin shooting to the tragedy in Charleston, it’s that Americans are decidedly not “over” racial discrimination. As a parent of white children, it’s my duty to teach them to use their privilege to be allies to those who do not share that privilege. My children were shocked as I explained to them how black mothers and fathers were afraid for their teenage sons, because they could actually be shot and killed, just for being teenagers.  “That’s not fair,” my son said. “That’s not right.” Exactly.

Then we talked about another flag: the rainbow flag that symbolizes the LGBT pride movement.  The Mormon church, along with many other conservative Christian churches, has been and continues to be a vocal opponent of gay marriage.  I actually do feel some empathy for people who fear that their deeply held religious convictions are being challenged by last week’s Supreme Court ruling supporting gay marriage. But in listening to some of my conservative Christian friends, I think there’s a basic misunderstanding of what the ruling really means. No church is going to have to marry gay people. The decision does not at all impact their religious freedom, any more than the long overdue imminent removal of the Confederate flag from South Carolina’s state capitol impacts individual freedom of speech.

I told my children that I think the First Amendment is one of the things that makes America a great country. Every person who wants to display the Confederate flag on his or her front lawn or white Chevy pickup truck should unequivocally have the right to do so. But any person who wants to fly the rainbow flag should and must have that same right. The government should not sanction discrimination of any kind. And as a parent, I have the power to teach my children tolerance and respect for differences and to encourage them to speak up for those who are oppressed.

That’s one thing I have learned from my conservative Christian friends: We shouldn’t be afraid to share our values. In the end, no matter what your family looks like—black, white, gay, straight, or some combination of all of these—the love you share is what matters. Love wins.


Thursday, June 18, 2015

It's Time to Talk about Fear and Love

What do guns, race, and mental illness have in common?
Charleston shooting demands difficult conversations about guns, race, and mental illness

James Holmes was obsessed with Batman. Elliott Rodger thought all women hated him and he needed to exact revenge. Adam Lanza killed innocent first graders, an act that shocked the collective national conscience. Now, in a country already reeling from racial turmoil, mass shooter Dylann Roof has targeted black churchgoers. All of the shooters were described as “quiet bright boys” who became increasingly isolated in their teens.  For all of them, numerous red flags were raised.

In his national response to the tragedy, President Obama observed what many have been saying for years: “This type of mass violence doesn’t happen in other advanced countries.” 
That’s not entirely true: Norway’s 2011 massacre, the attacks on Charlie Hebdo in France, and the Germanwings crash show that other nations experience unpredictable and senseless violence as well. But Obama’s still-valid point is essentially the same one muckraker Michael Moore made in Bowling for Columbine (2002). There’s something different about guns and America.

Let’s look at what we know about gun violence.

Fact: Mass shootings account for only about two percent of all gun violence in the United States. In 2015, only 133 of 5,767 deaths caused by gun violence were the result of mass shootings. In fact, you are much more likely to die in an airplane crash than in a mass shooting event. 

Fact: Blacks are disproportionately affected by gun violence. Though blacks make up only about 13 percent of the U.S. population, 55 percent of all people who died by homicide in 2010 were black

Fact: To date in 2015, there have been 2,025 reported and verified shootings involving law enforcement. It is hard to know exactly how high this number is because the government does not track police shootings. The Washington Post has reported 385 fatalities this year so far; The Guardian 470. According to a Pro Publica study, young black men are 21 times more likely to be shot by police than young white men. 

Fact: Suicide completion is the second leading cause of death for people ages 15-34, with 41,149 deaths by suicide completion across all age groups in 2013. Almost 60 percent of deaths by gun violence are completed suicides; the vast majority (87 percent) of suicide gun violence victims are male.

Fact: Based on studies of mass shooters, about half of the shooters suffered from serious mental illness. But the most common form of violence associated with mental illness is self-harm; more than ten percent of people diagnosed with schizophrenia and 15-17 percent of people with bipolar disorder die by completing suicide.

President Obama acknowledged that gun control is not going to happen, not even when a Bible study group is gunned down by a young man obsessed with white supremacist dogma. That’s why it’s up to each of us to face up to what guns, race, and mental illness represent in America. The seemingly endless and unproductive debates are really about our fear. It’s time to change that conversation.

How do we solve the gun issue?

We all look in the mirror and admit that we are afraid to die. We acknowledge that we likely will have no control over the time, place, or manner of our deaths. Then we start living. As part of our commitment to overcoming fear, we educate ourselves, practice responsible gun ownership, and teach it to our children. (Also, we start tracking data about law enforcement and gun violence.)

How do we solve the race issue?

We all look in the mirror and say, “I’m human. So is everyone else, no matter what color his or her skin is.” Then we start to treat people the way we want to be treated. We hold doors open for people of all genders and races. We write thank you notes to each other and buy each other’s coffee in the drive through lines. If we’re white, we recognize that we have privilege, and we fight even harder for the rights of those who do not share that privilege.

How do we solve the mental illness issue?

We all look in the mirror and say, "Mental illness is not a choice or a character flaw." Then we end stigma and provide treatment. Mental illness is a costly public health crisis, in both financial and ethical terms.  U.S. Representative Tim Murphy has reintroduced his “Helping Families in Mental Health Crisis Act” with significant revisions that can help individuals, families, and communities to improve access to care. 

In the wake of mass shootings, I used to write about the need to provide treatment before tragedy. My new message is this: enough about tragedy. Let's focus on treatment. Treatment provides hope, and love overcomes fear.

The American writer Thomas Wolfe wrote, “To believe that new monsters will arise as vicious as the old, to believe that the great Pandora's Box of human frailty, once opened, will never show a diminution of its ugly swarm, is to help, by just that much, to make it so forever.” Let’s stop believing in new monsters and start hoping instead for an America that can overcome its fear—of guns, of race, and of mental illness. Today we may feel lost and hopeless and afraid. But as Nelba Marquez-Greene, a grieving mother who lost her six year old daughter to gun violence, said one month after her daughter’s senseless death, “We choose love. Love wins in Newtown, and may love win in America.” 
   
I'm betting on love.

Tuesday, June 16, 2015

Same Old Stigma

Brian Wilson’s Biopic Shows Little Love or Mercy for Psychiatry

As the mother of a teenager who has bipolar disorder and a mile-wide creative streak, I was pretty excited to see the new Beach Boys biopic, Love and Mercy.  Composer and musician Brian Wilson has been completely and heroically transparent about his struggles with mental illness. Diagnosed with schizoaffective disorder, Wilson works tirelessly to promote an end to stigma through creative projects like the SMiLE sessions.  

But sadly, the movie was not at all what I expected. As an all-too-familiar modern fairy tale of the evil psychologist overmedicating and imprisoning a creative genius, Love and Mercy contributes to the merciless stigma that surrounds mental illness. Most stories have a beginning, a middle, and an end. Love and Mercy, with its deliberately framed stories of Brian Wilson’s success and subsequent mental illness, oversimplifies Wilson’s journey, pitting Eugene Landy (note: Landy is not a psychiatrist) against the fairy princess Cadillac saleswoman who becomes Wilson’s wife. The middle of the story, where Landy coaxed Wilson from three years in bed and a 150 pound weight gain 
to regain some semblance of his creative life and artistic promise, is only alluded to in the film, and the post-Landy period is a mere blurb as the end credits roll. 

Yes, Landy was a bad guy. Love and Mercy’s Paul Giamatti does a brilliant job at showing Landy’s failures, but the fact that the story is true does not make it any less damaging, at a time when the profession of psychiatry is desperate to attract talented physicians in the face of a growing public health crisis. Worse, it's not the whole truth: While what Eugene Landy did to Brian Wilson was truly horrible, Brian Wilson's life before Landy was arguably worse, which is certainly not a justification, but it does show just how awful life can be for people with serious mental illness.  

For the many thousands of children and adults who are in prison, or live homeless on the streets, a mental health professional can be a guide on the path to help and hope. Contrary to myriad negative media portrayals of psychiatrists, most mental health professionals are dedicated to improving their patients’ lives. That has certainly been my son's experience. Yet a 2014 study concluded that “medical students enter medical school with distinctly negative attitudes toward a career in psychiatry compared with other specialties,” which explains why only three percent choose to specialize in psychiatry each year. 

Love and Mercy is just the most recent example of an unbalanced cinematic portrayal of mental healthcare professionals, what Sharon Packer has termed “cinema’s sinister psychiatrists.”  In a study of mainstream movies, Wedding and Neimic (2014) found that for every balanced portrayal (Antwone Fisher, Ordinary People), there were four times as many unbalanced portrayals (What About Bob, Silence of the Lambs, One Flew Over the Cuckoo’s Nest, etc.) . 

The whole Love and Mercy story is this: Brian Wilson regained his life because of his family, his mental healthcare providers, and his own desire to seek recovery. As he told Ability Magazine in a 2014 interview, "Yes, I’ve been seeing a psychiatrist once a week for 12 years now, and he’s become a really close friend of mine. We talk and he helps me out.”   He also takes medication to manage his condition 

I'm not suggesting that Eugene Landy’s treatment of Brian Wilson was anything but unethical and immoral. It's just not the whole story. For every bad mental health professional like Landy, there are many more good mental health professionals, like the UCLA doctors who correctly diagnosed Wilson, or his current psychiatrist. All I’m asking is that Hollywood tell that story—the story where Wilson is correctly diagnosed, finds the right treatments and supports, and lives the life he deserves.

Monday, April 27, 2015

Behind Dr. Oz's Curtain

My son's pictures on the Dr. Oz Show, September 9, 2014
What’s Really “Nuts or Normal?”

“Pay no attention to that man behind the curtain.”—The Wizard of Oz, 1939

I don’t watch much television. In the aftermath of September 11, 2001, when I was shocked to see my then four-year old son crash his toy airplanes into towers built of blocks, I decided we didn’t need cable television and 24-hour news anymore. All the news was bad. And the rapidly expanding reality TV genre was worse. My children were raised on a media diet of PBS (delivered via old-fashioned rabbit ears) and DVD science documentaries we checked out from the library.

That being said, I’ve been on television more than some people, usually to talk about the increasingly desperate need to address the public health crisis of mental illness (one of my children has bipolar disorder). I’ve appeared on national media including the Today Show, Good Morning America, Anderson Cooper 360, Erin Burnett, and Al Jazeera America. I’ve done numerous local broadcast interviews, most recently in Bismarck, North Dakota and Cincinnati, Ohio.  

I was even fortunate to be a guest on the Dr. Oz show last year to talk about my book. Though I don't watch much television, I knew who he was, mostly from his syndicated column that appears on Sundays in my local newspaper. And while I was also vaguely aware of controversy about some of the weight loss methods promoted on his show, I didn’t understand why people wouldn’t just do their own research. There aren’t many times the word “always” is appropriate, but I think it’s fair to say that “Get Rich Quick” and “Lose Weight without Diet or Exercise” promises are almost always too good to be true.

I’m a bit puzzled by the credibility that people attach to television celebrities. The medium’s first duty is clearly to entertain; daytime television never even pretended that it had an obligation to educate.  What are your ethical obligations, then, if you’re a daytime television celebrity physician who calls himself “America’s Doctor”? How do you entertain your audience while also upholding your Hippocratic oath to protect the individual patient’s health and privacy?

In light of this flurry of Dr. Oz criticism, including calls for his resignation from the staff of Columbia University’s medical school, my fearless friend and fellow mental health advocate Janine Francolini of the Flawless Foundation has been quick to remind the public of the Dr. Oz show’s truly terrible 2012 series “Are You Normal or Nuts?” in which a panel of “top psychologists” evaluated audience members’ mental health concerns. 

This truly tasteless show echoed an equally tacky Reader’s Digest annual feature by the same name, which trivializes the tremendous suffering experienced by individuals diagnosed with serious mental illness and their families. For example, the 2013 "Normal or Nuts" article led with this charming introduction: “Calling all neurotics, paranoids, and phobics! Our panel of experts says you might not be as loony as you think in this fan-favorite feature.”

And people wonder why there’s still stigma attached to mental illness.

Like Janine, I want Dr. Oz to use his celebrity status to promote mental health. In my personal experience with him, that’s exactly what Dr. Oz did.

“I’m a dad, and this is important to me,” he told me before we began taping a segment discussing my experience as a parent of a child who has bipolar disorder. His approach to my family’s story was overwhelmingly positive, highlighting the tremendous gains my son has made since his diagnosis in May 2013. The audience applauded when I shared that my son has now written a book of his own, a science fiction novel where the Greek gods all have a mental illness that is actually a super power. This is what the correct diagnosis and treatment can mean to parents and children suffering with mental illness. It means hope.

Dr. Oz has tremendous power to shape public opinion about mental health and mental illness. How can we encourage him to use his power for good, like he did for me and my son? When it comes to mental illness, sadly, too many Americans are still like star-struck Dorothy, believing in the all-powerful image of Oz, not willing to look behind the curtain and acknowledge the truth.

I have an idea for this season’s “Are You Nuts or Normal?” producers. Dr. Oz invites panelists to rate people like Judge Michael Bohren, who refused to authorize medical treatment for 12-year old Morgan Geyser, diagnosed with paranoid schizophrenia and locked up away from her family and denied medical treatment for her brain disease for almost a year.

Nuts or normal?

Dr. Oz interviews the six police officers who tasered 130-pound Natasha McKenna, diagnosed with schizophrenia, and asks them to explain why she died in custody. 

Nuts or normal?

Finally, Dr. Oz presents British parliamentary candidate Chamali Fernando so that experts can discuss her suggestion that people with mental illness should wear color coded wristbands. 

Nuts or normal?

The way we fail to treat children and adults with mental illness in this country is what is really crazy. It’s also expensive, not only in financial terms, but also in lives lost, in dreams shattered. Dr. Oz could rebuild his credibility by focusing his attention on this public health crisis, by providing help—and hope—to millions who are suffering with serious mental illness. 

Saturday, April 18, 2015

The Lost Weekend

Where were my children? Photo by Jonathan Malm,
http://www.freeimages.com/photo/90334
In high conflict divorces, it’s best to stick to the agreement, even when it hurts

I don’t talk much about my ex-husband or our extremely high conflict divorce. But I recently discovered Tina Swithin’s epic One Mom’s Battle blog, in which she details in blow-by-blow, excruciating detail, what it was like to divorce a narcissist. I couldn’t have found it at a better time.

Unless you’ve been there, it’s hard to understand. In the spirit of solidarity with Tina and so many other mothers, here’s a little glimpse of my life.

On Wednesday at 3:45, I left work early, like I always do on Wednesdays, to drive to my younger two children’s schools and pick them up. It had been an incredibly stressful week, with last minute projects and deadlines, so I was eager to leave work behind and enjoy my time with my family. I hummed as I thought about the weekend ahead: the forecast was sunny and warm. Maybe we could go for a family hike on Saturday.

When I pulled up at my son’s school at 4:00, I knew something was wrong. There were only a few cars in the parking lot, and no children were waiting outside or walking home. I went inside. “Maybe he’s in the library,” I thought. Worried, I sent my son a quick email. “I'm wandering all over campus looking for you--can you check in with me if you are by a computer? Or did you walk to your sister’s school?

It was close to the time I needed to pick up my daughter. Unsure of what to do, I decided to go to her school, then return to look for my son. Her school’s parking lot was also almost empty. I went to the gymnasium where she usually participates in after school jump rope club. “There’s no school today,” a teacher told me.

I was suddenly sick to my stomach. No school. On a Wednesday. Then where were my children? I did something I haven’t done in five years: I called their father. Of course, he didn’t answer, so I left a message. “Hey, there’s no school, apparently. Are the kids with you? Where would you like to meet so I can pick them up?” I also emailed him, “I'm at the school to pick up X from jump rope club and was just informed there is no school today. Where are X and X? Where should I pick them up? Or do you plan to drop them at the clubhouse? Please let me know as soon as possible.”

I had now tried to contact my kids and my ex five times in the course of 15 minutes. I put my head on the steering wheel and started to sob.

It was 4:31. My ex emailed me this: “we waited but you never showed up.”

My mind was racing. What did my current custody agreement say about days when there was no school? There have been so many changes to our agreement over the seven years we have been divorced.

So I emailed back, asking where we could meet to exchange the children.

My ex’s 542-word response had quite obviously been prepared ahead of time. I’ll just share the last bit: “You were not on time for the ordered exchange.  You made us and the children wait and wait.  That’s not good for the children. The court order says if you don’t make the exchange, you forfeit your visitation period.  That language was per the recommendation of (court ordered psychologist) because of your past pattern of actions like today's--creating crises and causing drama and involving the police etc.  We are done with your drama.  The order says show up on time or miss your visitation period.”

Yep, the reality was this: my ex-husband bet (correctly) that I would forget about the Wednesday in-service day. My other children are in a different school district and had school as usual. So my children’s father drove all the way across town with my son and daughter. He did not answer my phone call. He did not respond to my email. He just waited, like a spider in the center of a web, for me to not show up—because I was on the other side of town at the kids’ schools.

You may be scratching your head at this point. Most divorced parents manage this kind of mix-up easily. For example, one parent might politely remind the other parent that there is no school and confirm the drop off location. Or a parent might text, hey, I’m at the kids school, but they aren’t here! And the other parent could respond, no school. We went to drop off location—headed home now since you weren’t there. Want to meet in the middle? And the first parent would respond, sure, so sorry for mix-up.

That’s not how it works in my world. In my world, we stick to the agreement. We only communicate through email and non-emergency police dispatch. In my world, it’s not about what’s best for the children. It’s about payback.

The thing is, my ex is right on some levels. I should have known the kids didn’t have school on Wednesday. And we need to follow the agreement. Honestly, making exceptions to the agreement is bad for both of us; I am still resentful about the concessions I have made to him in the past, and it’s my own fault for making those concessions. I understand that my ex feels that the agreement should always apply to me and never to him. I need the protections of this agreement in many ways. While I’m sad I don’t get to spend my weekend with my children, I’ve also learned some valuable lessons. Most of all, I’m relieved that they are safe. There’s no worse feeling, as any mother knows, than not knowing where your children are.

I stopped by my children’s schools at lunchtime the next day, to apologize for my mistake. I gave them each a “date with mom” coupon so we could plan our next adventures together. At the end of the day, I’m fortunate to have smart, fun, capable children who love me—and I love them.

It’s been harder for me to forgive myself. My time with my children is precious. Also, because I was so flustered and worried, my ex was able to get me to engage at first. For example, I threatened to call his LDS bishop and report this. I also said I would file a police report. I’m not going to do either. I refuse to engage emotionally for even a single minute more. Instead, I’m going to enjoy that weekend hike, with my husband.

And next time I see my younger children, we’re going to have so much fun!

P.S. If you have a high conflict divorce, here are a few great resources for you:

Divorcing a Narcissist by Tina Swithin. Reading this agonizing tale made me realize that I actually have it pretty good. I don’t think my ex is a full blown narcissist. But he is very controlling and always has to be right. His favorite phrase is "The court order says." Apparently, this phrase only applies to me. Smiley face.

Why Is It Always About You? The Seven Deadly Sins of Narcissism by Sandy Hotchkiss and James Masterson, M.D. This book really helped me to understand my marriage and why I started to disappear. It has also helped me to make better choices in my subsequent relationships.

The No Asshole Rule: Building a Civilized Workplace and Surviving One that Isn’t, by Robert I Sutton. Narcissism in the workplace can be toxic. Sometimes the only solution is to leave.

You might also want to check out www.wevorce.com or www.ourfamilywizard.com. I'll be sharing more about wevorce in a subsequent blog.

One final note: if you are divorcing a narcissist, you should be emotionally prepared to spend quite a bit of time in court. We have changed our custody agreement five times in seven years. But you should also know that as you heal and find yourself, you'll find the life you (and your children) deserve.

Sunday, April 5, 2015

The Dangerous Illusion of Safety

What a German co-pilot’s death and a Jewish rabbi’s life teach us about love

In 1984, I was 12 years old. That summer, my mother handed me two worn paperback books: George Orwell’s 1984 and Aldous Huxley’s Brave New World. “Read them both,” she told me. “Then tell me which one you think is more likely to come true.”

In 1984, I chose Huxley, with his seductive dystopian future shaped by caste systems and fueled by a pleasure drug that rendered life pleasant but meaningless.

In 2015, with our terrorized, NSA-monitored, trigger-happy America, I choose Orwell and his future built on fear and the dangerous illusion of safety.   

For me and for many, this Easter season has been overshadowed by yet another tragedy involving a young man with mental illness. This time, the weapon of destruction was an airplane, not a gun, and it proved far more deadly than other tragedies like Sandy Hook or Columbine. Yet like the school shootings, the essential purpose of the Germanwings crash was the co-pilot’s suicide.

While tabloids could not resist inflammatory headlines like “Madman in the Cockpit,” 
for the most part, the mainstream news outlets were respectful and cautious, stressing the outlier nature of the tragic incident that claimed 150 lives and calling for an increased focus on improving mental healthcare for everyone. Two years after Newtown, this balanced approach shows that we have come a long way as a society in how we understand mental illness.

But the “blame and shame” comments on these articles demonstrate that we still have so far to go. 

Orwell’s book described a society controlled by fear. I would suggest that our society is swiftly moving along this exact trajectory, and that the way we treat people who have mental illness demonstrates how Orwellian fear can be used to control public opinion.

As one example of how we have traded reason for fear, in the wake of the Germanwings tragedy, a journalist with a major news outlet actually asked a mental health policy expert friend of mine, “Is it safe to fly?”

This question demonstrates our incredible inability as a species to assess risk. In fact, it is still safe to fly, much safer than driving to the grocery store. In 2013, for example, there were 32,719 automobile crash fatalities, and only 443 aviation related deaths. This year won’t be much different, even with the Germanwings disaster.

The way we think about violence and mental illness also reveals how we fail to understand risk. While it is true that school shooters are more likely than the general population to have mental illness, the vast majority of gun-related violence is not associated with mental illness. The U.S. Centers for Disease Control and Prevention has tracked school-related violence since 1992: in the entire United States, between 14 and 34 youth die violently at school each year. To put that number in perspective, in Chicago alone, more than 300 young people between the ages of 10 and 25, mostly young men, were killed by guns in 2008

The crux of our collective and irrational fear is this simple truth: we are all going to die. An almost statistically insignificant number of us will die in an airplane crash. More of us will die in car accidents or because of gun violence or by suicide. Many of us will live to old age, only to succumb to dementia, heart disease, or cancer. But one way or another, every one of us is going to die. Nothing can keep us safe from death.

Only when we embrace this essential condition of human existence—when we become comfortable with the inevitable truth of our ultimate ending—can we live a life that is truly free from fear.

For me, Easter is a celebration of this freedom. The celebration begins more than 2000 years ago with Christ’s bloody, agonizing exit from mortal existence, his lifeless body hanging on a cross, pierced by a Roman spear. The celebration ends with Christ’s mythical transcendence to divinity and allegorical return to the empty tomb. But Easter is really a celebration of radical love, the kind of love that makes all men and women our brothers and sisters, the kind of love that conquers death.

I think sometimes that we focus too much on the promise of the resurrection, of life everlasting, and too little on the Rabbi’s earthly message of love right here and now. At its heart, Easter teaches us to overcome our fear of the most cruel and brutal death possible, to embrace instead the life we were meant to live. Christ's life reminds us that a stranger from Samaria may save us, that the leper may be cured against all odds, and that none among us is perfect. Christ’s message was to “love one another,” to embrace the stranger, to help the poor, and to forgive.

Instead, our “Christian Nation” has adopted an Orwellian illusion of safety and rejected the inherent risk of Christ-like selfless, radical love. We do not love one another. We do not embrace the stranger or help the poor; we blame them and incarcerate them. We do not forgive trespasses; we harbor grudges, as individuals, as communities, and as nations.

Here’s the question I have for you on Easter: What if this life is all we have? That is the question we are asking ourselves, in the wake of a senseless airplane crash that could have been prevented, if only (mental health care, no stigma, social support networks, etc.).

The question we should be asking ourselves is this: “How do I live the best life I am capable of living, here and now, today?”

Only by answering this question can we overcome the Orwellian culture of fear that is dividing the world into smaller and smaller islands of false safety. None of us can escape death. But Christ’s death should have taught us this: we all have a sacred duty to love.